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For Peer Review Only ABUSIVE USE OF ANTIBIOTICS IN POULTRY FARMING IN CAMEROON AND THEIR PUBLIC HEALTH IMPLICATIONS Journal: British Poultry Science Manuscript ID CBPS-2015-290.R1 Manuscript Type: Original Manuscript Date Submitted by the Author: 09-Feb-2016 Complete List of Authors: Guetiya Wadoum, Raoul Emeric; University of Dschang, Biochemistry; University of Roma Tor Vergata, Biology; University of Camerino, Comparative Morphology and Biochemistry Zambou Ngoufack, Francois; University of Dschang, Biochemistry Fonteh Anyangwe, Florence; University of Dschang, Animal Production Njimou, Jacques Romain; University of Rome I “Sapienza”, Chemical Materials, Environmental Engineering Coman, Maria Magdalena; University of Camerino, Comparative Morphology and Biochemistry Verdenelli, Maria Cristina; University of Camerino, Comparative Morphology and Biochemistry Cecchini, Cinzia; University of Camerino, Comparative Morphology and Biochemistry Silvi, Stefania; University of Camerino, Comparative Morphology and Biochemistry Carla, Orpianesi; University of Camerino, Comparative Morphology and Biochemistry Cresci, Alberto; University of Camerino, Comparative Morphology and Biochemistry Colizzi, Vittorio; University of Roma Tor Vergata, Biology Keywords: Antibiotics Abuse, Antibiotics Residues, Maximum Residual Limit, Resistant Pathogens, Foodborne Diseases, Public Health E-mail: bps@tandf.co.uk URL: http://mc.manuscriptcentral.com/cbps British Poultry Science
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    ABUSIVE USE OF ANTIBIOTICS IN POULTRY FARMING IN

    CAMEROON AND THEIR PUBLIC HEALTH IMPLICATIONS

    Journal: British Poultry Science

    Manuscript ID CBPS-2015-290.R1

    Manuscript Type: Original Manuscript

    Date Submitted by the Author: 09-Feb-2016

    Complete List of Authors: Guetiya Wadoum, Raoul Emeric; University of Dschang, Biochemistry; University of Roma Tor Vergata, Biology; University of Camerino, Comparative Morphology and Biochemistry Zambou Ngoufack, Francois; University of Dschang, Biochemistry Fonteh Anyangwe, Florence; University of Dschang, Animal Production Njimou, Jacques Romain; University of Rome I “Sapienza”, Chemical Materials, Environmental Engineering Coman, Maria Magdalena; University of Camerino, Comparative Morphology and Biochemistry Verdenelli, Maria Cristina; University of Camerino, Comparative Morphology and Biochemistry Cecchini, Cinzia; University of Camerino, Comparative Morphology and

    Biochemistry Silvi, Stefania; University of Camerino, Comparative Morphology and Biochemistry Carla, Orpianesi; University of Camerino, Comparative Morphology and Biochemistry Cresci, Alberto; University of Camerino, Comparative Morphology and Biochemistry Colizzi, Vittorio; University of Roma Tor Vergata, Biology

    Keywords: Antibiotics Abuse, Antibiotics Residues, Maximum Residual Limit, Resistant Pathogens, Foodborne Diseases, Public Health

    E-mail: bps@tandf.co.uk URL: http://mc.manuscriptcentral.com/cbps

    British Poultry Science

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    ABUSIVE USE OF ANTIBIOTICS IN POULTRY FARMING IN

    CAMEROON AND THEIR PUBLIC HEALTH IMPLICATIONS

    Guetiya Wadoum Raoul Emeric1,2,3*

    1Department of Biochemistry, Faculty of Sciences, University of Dschang, Cameroon

    2Department of Biology, University of Rome II “Tor Vergata Rome”, Italy

    3Department of Comparative Morphology and Biochemistry, University of Camerino, Italy

    E-mail: raoulemeric@yahoo.fr; Tel: Cameroon: 00237-699898834; 00237-672478872; Italy:

    0039-3286658872; Sierra Leone: 00232-78425924; 00232-99520028; P.O. Box 67 Dschang,

    Cameroon

    Zambou Ngoufack François1

    1Department of Biochemistry, Faculty of Sciences, University of Dschang, Cameroon

    E-mail: Tel: 00237-677811129; P.O. Box 67 Dschang, Cameroon.

    Fonteh Anyangwe Florence4

    4Department of Animal Production, Faculty of Agronomy and Agricultural Sciences, University of

    Dschang, Cameroon; E-mail: ; Tel: 00237-696818469; P.O. Box 96, Dschang, Cameroon

    Njimou Jacques Romain5

    5Department of Chemical Materials, Environmental Engineering, University of Rome I “Sapienza”,

    Italy; E-mail: ; Tel: Italy: 0039-3204477178; Cameroon: 00237-675036570; P.O. Box 812,

    Yaounde, Cameroon

    Maria Magdalena Coman3

    3Department of Comparative Morphology and Biochemistry, University of Camerino, Italy

    E-mail: ; Tel: 0039-0737402402; P.O. Box : Via Gentile III da Varano 62032 Camerino (MC), Italy

    Verdenelli Maria Cristina3

    3Department of Comparative Morphology and Biochemistry, University of Camerino, Italy

    E-mail: ; Tel: 0039-0737402405; P.O. Box : Via Gentile III da Varano 62032 Camerino (MC), Italy

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    Cinzia Cecchini3

    3Department of Comparative Morphology and Biochemistry, University of Camerino, Italy

    E-mail: ; Tel: 0039-0737-402405; P.O. Box : Via Gentile III da Varano 62032 Camerino (MC),

    Italy

    Stefania Silvi3

    3Department of Comparative Morphology and Biochemistry, University of Camerino, Italy

    E-mail: ; Tel: 0039-0737-402405; P.O. Box : Via Gentile III da Varano 62032 Camerino (MC),

    Italy

    Orpianesi Carla3

    3Department of Comparative Morphology and Biochemistry, University of Camerino, Italy

    E-mail: carla.orpianesi@unicam.it; Tel: 0039-0737402404; P.O. Box : Via Gentile III da Varano

    62032 Camerino (MC), Italy

    Alberto Cresci3

    3Department of Comparative Morphology and Biochemistry, University of Camerino, Italy

    E-mail: ; Tel: 0039-328 8604250; P.O. Box : Via Gentile III da Varano 62032 Camerino (MC),

    Italy

    Vittorio Colizzi2

    2Department of Biology and scientific research, University of Rome II “Tor Vergata Rome”, Italy;

    E-mail: ; Tel: Rome: 0039-0672594237; Fax: 0672594224;

    Italy: 0039-3478312155; Cameroon: +237-696777148; Sierra Leone: 00232-76595077

    *Corresponding author:

    Guetiya Wadoum Raoul Emeric, Laboratory of Biochemistry, Food Science and Nutrition

    (LABPMAN), Department of Biochemistry, Faculty of Science, University of Dschang, E-mail:

    raoulemeric@yahoo.fr; Tel: Cameroon: 00237-699898834; 00237-672478872; Italy: 0039-

    3286658872; Sierra Leone: 00232-78425924; 00232-99520028; P.O. Box 67 Dschang, Cameroon

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    ABSTRACT

    1 This study aimed to investigate the types and way of usages of antibiotics in poultry

    farms, their residual levels and the potential microbial resistances.

    2 A questionnaire-based survey identified the different antibiotics used and High

    Performance Liquid Chromatography (HPLC) was used to determine antibiotics residual

    levels.

    3 Pathogens were isolated, identified by use of API kits and Minimum inhibition

    Concentration (MIC) was determined.

    4 Oxytetraxyclin, Tylocip and TCN were the most frequently used antibiotics. The

    antibiotics screened during HPLC were Chloramphenicol, Tetraxyclin and Vancomycin.

    All of them except Vancomycin were detected, and the concentration of these antibiotics

    was higher than the limit set by regulatory authorities Maximum Residual Limit (MRL).

    5 However, no residues of various antibiotics were found in egg albumen or yolk.

    Furthermore, the concentration of Tetraxyclin was significantly high (p

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    1. INTRODUCTION

    The growth promoter effect of antibiotics was discovered in the 1940s, when it was

    observed that animals fed dried mycelia of Streptomyces aureofaciens containing

    chlortetracycline residues improved their growth. Their mechanism of action when used as

    growth promoters was early related to their interactions with intestinal microbial population

    (Dibner and Richards, 2005; Niewold, 2007).

    Nowadays, the use of antibiotics as growth promoter in developing counties such as

    Cameroon has facilitated the efficient production of poultry allowing Cameroonians to

    purchase, at a reasonable cost, high quality meat and eggs. Although these uses benefit all

    involved, unfortunately, the edible poultry tissues may have harmful concentrations of drug

    residues.

    In fact, antibiotics are substances either produced naturally by living organisms or produced

    synthetically in the laboratory, and they are able to kill or inhibit the growth of

    microorganisms. Also, they can be classified according to their effects as either bactericidal

    or bacteriostatic and according to their range of efficacy as narrow or broad in spectrum.

    Theirey use in animals shortly followed their use in humans for the purpose of disease

    prevention and treatment (Gustafson, 1993). It have been also demonstrated that, the major

    antibiotics used for humans either belong to the same general classes or have the same

    mode of action as those used for animals (Joshi, 2002 Gelband et al., 2015).

    Today, antimicrobial drugs are used to control, prevent, and treat infection and to enhance

    animal growth and feed efficiency (Haihong et al., 2014Tollefson and Miller, 2000).

    Currently, approximately 80% of all food-producing animals receive medication for part or

    most of their lives. The most commonly used antimicrobials in food-producing animals are

    the β-lactams, tetracyclines, aminoglycosides, lincosamides, macrolides, pleuromutilins,

    and sulfonamides (De BriyneLee et al., 201401). Nevertheless, the use of these antibiotics

    in food-producing animals canmay leave residues in foodstuffs of animal origin like meat,

    milk, and eggs.

    A chemical residue is either the parent compound or its metabolites that may deposit

    accumulate or otherwise be stored within the cells, tissues, organs or edible products of

    animals following its use to prevent, control or treat animal disease or to enhance

    Formatted: Font: Italic

    Formatted: Font: Italic

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    production (Riviere and Sundlof, 2001). Antibiotic residues in foods from animal origin

    may be the cause of numerous health concerns in humans. They range from direct toxicity

    on consumers exhibiting allergy reactions, immunopathological diseases, carcinogenicity

    effects (e.g., sulphamethazine, Oxytetraxyclin, and furazolidone), mutagenicity,

    nephropathy (e.g., Gentamycin), hepatotoxicity, reproductive disorders, bone marrow

    toxicity (e.g., Chloramphenicol), allergy (e.g., penicillin) and the destruction of useful

    microflora present in the gastro-intestinal tract especially of children leading to indigestion

    (Nisha, 2008; Nonga et al., 2010); to indirect hazard through the generation of resistant

    strains of pathogenic bacteria which can be transfer to human and the residual

    contamination of manures used in crop productions (Dubois et al., 2001; Kaitlin, 2013).

    Grote et al. (2007) showed in model farming experiments that even plants can take up

    antibiotics from manure present in soil. This raised concern as antibiotic residues might be

    transferred into plants in amounts that could pose a health risk for consumers

    (BfRBundesinstitut für Risikobewertung, 2001).

    These various health risks led to withdraw approval for antibiotics as growth promoters in

    the European Union since January 1, 2006. However, in other to ensure consumer safety,

    worldwide regulatory authorities have set MRL’s (Maximum Residual Limit) for several

    veterinary drugs (European Union EEC, 1990; Codex Alimentarius Commission CAC,

    2012). These MRL’s, are expected to regulate the maximum permitted levels of the drug

    residue for each antibiotic which is considered safely acceptable in food of animal origin

    (Woodward, 1993).

    Moreover, the development of antimicrobial resistant bacteria strains of animal origin

    associated with antibiotic residues and its consequent effect on human health regarding the

    efficacy of antimicrobial therapy (Casadevall, 1996; Threlfall, 2002; Phillips et al., 2004)

    have become a worldwide public concern (Akbar and Anal, 2014). According to Prescott

    and Baggot (1993), microbial resistance to antibiotics, particularly aminoglycosides

    (Streptomycin, Neomycin, and Kanamycin) is very common and pathogens present in

    foodstuffs of animal origin mainly S. aureus, E. coli O157:H7 and L. monocytogenes may

    easily develop antimicrobial resistance (Tanih et al., Griffin and Tauxe, 19912015).

    Formatted: Pattern: Clear

    Formatted: Pattern: Clear

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    Therefore, monitoring antibiotics residues and the presence of pathogenic bacteria in

    animal derived food for human consumption has to be one of the most important duties for

    public health agencies (Samanidou et al., 2008). Despite this recommendation, there is no

    clear regulation for control of such residues and pathogens in animal products for human

    consumption in many African countries particularly in Cameroon.

    The aim of this study was to investigate on the use of antibiotics by poultry farmers in one

    of Cameroon’s important agro-pastoral region (Western Highlands), determine the residual

    levels of some antibiotics by High Performance Liquid Chromatography (HPLC) and

    establish the resistance profile of isolated pathogenic bacteria in other to demonstrate the

    public health hazards.

    2. MATERIALS AND METHODS

    2.1 Localization of the study

    The study was conducted in the Western Highland of Cameroon which is an important

    agro-pastoral area of the country. The geographical references of the Western Highlands of

    Cameroon are latitude 5° 20' and 7° North and longitude 9°40' and 11°10' East of the

    Equator (Nchinda and Mendi, 2008). This area includes two administrative Regions

    namely: the North-west Region with the town of Bamenda being the headquarters and the

    West Region with the town of Bafoussam as headquarters. Elevations reach as high as

    3011 m and as low as 500 m above sea level, with the highest points being Mt. Bamboutos

    2740 m in the West Region and Mt. Oku 3011 m in the North West Region. The climate is

    marked by a short dry season from November to mid March and a long rainy season from

    mid March to October. Rainfall ranges between 1300-3000 mm with a mean of 2000 mm.

    Minimum and maximum temperatures have means of 15.50°C and 24.5°C, respectively;

    although temperatures can go above 30°C. Three types of soils exist in the western

    highlands: volcanic, hydromorphic and ferralitic soils. The human population is estimated

    at 1.82 million inhabitants, being one of the highest population densities in the country,

    with at least 79 inhabitants per km2 and a population growth rate of 3.1% (Nchinda and

    Mendi, 2008). This agro-pastoral area was purposively chosen, because he has the largest

    number of small and large scale poultry farms in Cameroon and contributing to about 56%

    of poultry production in Cameroon (Ngatchou and Teleu, 2006; Keambou, 2013).

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    2.2 Questionnaire-Based Survey on Major Farms

    A Questionnaire-based survey in English and French was conducted on one hundred and

    thirty one (131) poultry farms to identify the most commonly used antibiotics, their dosage,

    timing of use and the practiced withholding times prior to dispatch. Between February and

    October 2012, several farms chosen randomly were contacted; only 131 agreed and

    participated between December 2012 and June 2013 to the survey. The georeference of

    each poultry farms was collected by the use of a Global Positioning System (GPS) receiver

    (GPSmap 76CSx, Garmin) and the softwares Google Earth, Global Mapper, Map Source

    and Adobe Illustrator CS4 were used to generate the map of the site.

    2.3 Public health hazard

    2.3.1 Identification and quantification of antibiotic in edible tissues and eggs by HPLC

    2.3.1.1 Ethics statement

    Animal experiments were performed according to the guidelines set for the care and use of

    laboratory animals and with the rules formulated under the Animal Welfare Act by the

    United States Department of Agriculture (USDA) and by adopting ARRIVE guidelines

    (Kilkenny et al., 2011).

    2.3.1.2 Preparation of samples

    Eighty five Chickens (35 Layers and 50 Broilers) were randomly collected in various

    poultry farms without prior information to the farmers, killed by section of the jugular vein

    and muscle, liver, heart, kidney and gizzards were sampled aseptically from each carcass.

    The randomization process was performed in laying Hen farms by selecting an equal

    number of animals in each corner of the pen without showing any preference while in

    broiler farms,; an equal number of animals were collected in each corner of the pen with

    consideration to have an equal amount of sex. FurthermoreAlso, 20 samples of each tissue

    were collected from commercial barbecued sale points. At the same time, eggs samples (35

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    from poultry farms and 20 from commercial sale points) were randomly collected and

    placed in sterile polyethylene containers.

    Prior to High Performance Liquid Chromatography (HPLC) analysis, a qualitative

    evaluation was performed through microbiological inhibition assay (“data not shown”) as

    describe by Javadi et al. (2011), with the difference that the test organisms used were

    Bacillus cereus (ATCC 11778), Staphylococcus aureus (ATCC 25922) and Escherichia

    coli (ATCC 13706) and also due to the fact that samples supernatant were used rather than

    tissues. Positive samples were selected for HPLC analysis.

    2.3.1.3 Extraction and Quantitative Evaluation

    The positive samples obtained (T= 41: 5 samples of each tissue, 8 albumen and 8 yolk)

    were dissolved in ultrapure water according to the ratio 0.3 g of sample in 10 mL and

    centrifuged at 2647 g for 10 min. The supernatant was filtered through a 0.20 µm cellulose

    acetate membrane filter (Schleicher & Schuell, Roma, Italy) and used for analysis. A

    portion of 25 µl of the filtrate was injected into the HPLC system for analysis. This analysis

    was performed on an Agilent Technologies 1200 HPLC system fitted with a SUPELCOSIL

    LC-18 column (length 250 mm, diameter 4.6 mm, packaging size 5 mm, TK

    mediterranea™ Sea 18, Roma, Italy) with ultra violet (UV) detector. The column

    temperature was settled to 20°C. The mobile phase consists of an aqueous solution of 0.5%

    volume acetic acid (“A”) and acetic nitrile (“B”). Elution was performed as follows: At

    the beginning and during the first 2 min of run, 100% of “A”; from 2 min to 40 min after

    the beginning, a linear ramp was used, targeting 40% of “A” and 60% of “B”. The flow rate

    was settled to 1 ml/min and antibiotics were detected by a UV detector (280 nm, TK

    mediterranea™ Sea 18, Roma, Italy). Beforehand, the retention times of the interest

    antibiotics compounds (Tetraxyclin, Chloramphenicol and Vancomycin purchased from

    Oxoid) were measured by using single antibiotic standard solutions at a concentration of

    100 mg/l. These antibiotics were selected due to the high percentage of use by poultry

    farmers as reveal by the survey. The Detection Limit (DL) was defined as the concentration

    of antimicrobial that produces an analytical signal equal to thrice the standard deviation of

    the background signal and calculated as 8 ng/g.

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    2.3.2 Susceptibility to antibiotics of isolated poultry pathogens

    2.3.2.1 Isolation and Identification

    The collection of faeces was carried out on living birds localized at different geographical

    area according to the swab method as described by the International Organization for

    Animal Health (OIE) in the Terrestrial Manual (OIE, 2005). After sampling, pathogenic

    bacteria were isolated from 45 swab samples following the procedure describe by Aly et al.

    (2004). The selective growth media Manitol salt agar (Biolife®, Milano, Italy), Listeria

    agar (Biolife®, Milano, Italy), Pseudomonas cetrimide agar (Oxoid, UK), Reinforce

    clostridia agar (Oxoid, UK) were used to isolate respectively Staphylococci sp., Listeria sp.,

    Pseudomonas sp. and Clostridia species. Also, the semi-selective growth media Salmonella

    and Shigella agar (Merck, Darmstadt, Germany), XLD agar (Biolife®, Milano, Italy) were

    used to isolate respectively Shigella sp., and Salmonella species. Finally, Mac Conkey agar

    (Conda, Madrid, Spain) was used to isolate other Enterobacteriaceae. All media and agar

    were prepared according to manufacturer’s recommendations and were inoculated then

    incubated at 37°C for 24–48 h. After incubation, colonies were examined for cultural and

    morphological properties on growth media. The selected isolates were identified by using

    API systems (API 20 E, API Staph and API 20 NE) galleries (Biomérieux, Marcy l’Etoile,

    France). Interpretations of the fermentation profiles were facilitated by systematically

    comparing all results obtained for the isolates studied with information from the computer-

    aided database API LAB Plus V3.2.2. (). All cultures were maintained as stocks in specific

    broth at -20°C with 15% glycerol.

    2.3.2.2 Determination of resistance profile of isolated pathogenic Bacteria

    The microdilution method was adopted and performed in a 96 wells microplate and MICs

    (µg/ml) were determined. The results of susceptibility status were interpreted according to

    the recent FEEDAP (Panel on Additives and Products or substances used in Animal Feed)

    document of the European Food Safety Authority (EFSA) on the update of the criteria used

    in the assessment of antibiotics bacterial resistance of human or veterinary importance

    (EFSA, 2008) and by the standards for antimicrobial disk and dilution susceptibility tests

    for bacteria isolated from animals approved by CLSI (Clinical Laboratory Standards

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    Institute), formerly National Committee for Clinical Laboratory Standards (NCCLS, 2002).

    Strains showing MICs less than CLSI’s breakpoints were considered sensitive; otherwise,

    they were resistant. The antibiotics including Ampicilin, Tetracyclin, Erythromycin,

    Amoxicillin-clavulanic acid, Chloramphenicol, Enrofloxacin, Gentamycin, Kanamycin,

    Vancomycin, Ceftiofur, and Trimethoprim-sulfamethoxazole obtained from Oxoid and

    Fluka were tested. The selection of these antibiotics was based on the CLSI’s

    comprehensive list of antimicrobial agents that could be considered for routine testing by

    veterinary microbiology laboratories (National Committee for Clinical Laboratory

    StandardsNCCLS, 2002).

    2.4 Statistical Analyses

    The computer program GraphPad InStat version 3.10 was used for the one-way analysis of

    variance (ANOVA). Student-Newman Keels means comparison test were use at a statistical

    significance pre-set at P

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    making informed decisions on choice, administration, storage and withdrawal periods of

    antibiotics upon veterinary advice and prescriptions (Table 1). However, is obvious that

    these farms managers didn’t implement farm hygiene and good antibiotic management

    have concerngiven their education level. to implement farm hygiene and good antibiotic

    management. Similar findings on farm staff educational backgrounds and their implications

    have been described by Turkson (2008). Moreover, the finding that as much as 89% of the

    farm staff had never been medically examined before in relation to their jobs, gave the

    impression that they did not care for being possible agents for transmission of zoonotic

    diseases.

    It is evident from that majority of farmers constantly used antibiotics as prophylaxis

    and more intensively during disease outbreaks for treatments. Although minority of the

    farmers purchased medicines on prescription, it was noticeable that 80% of farmers, in spite

    of their formal education, made their own diagnosis and prognoses of diseases that were

    occurring or about to occur and formed their own opinions on what antibiotics to buy

    (Table 2). Liberalization of antibiotic imports in Cameroon has made antibiotics easily

    available (reference). It seemed that veterinary drug sellers did not insist on certified

    veterinary prescriptions before sales. They could even suggest the diagnoses of diseases to

    farmers so that they could sell their drugs. The situation could lead to unnecessary use and

    overuse of antibiotics, their wrong combinations, quick changeover to other drugs and

    improper dosage (Annan-Prah et al., 2012Khan, 1975). The result would be the production

    of antibiotic resistant strains of bacteria (Khachatourians, 1998) and cross resistance with

    other bacteria (Baker-Austin et al., 2006; World Health Organization, 20143).

    From Table 3, it is apparent that the 26 drugs used in investigated farms could be

    grouped into antibiotics, formulations with low doses of antibiotics to be used as growth

    promoters, coccidiostats and an antihelminthic. Our results recorded that some of the

    antibiotics that were used neither gave information about their active ingredients nor their

    withdrawal periods. This usually occurred with imitated antibiotic products which could

    enter the country by unapproved routes to escape Veterinary Services, Food and Drugs

    Board and Standards Board’s approval and customs duties (Annan-Prah et al., 2012).

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    These results also indicate that Tylocip, TCN, Oxytetraxyclin and Amprolium powder were

    mostly used (Table 3). Tylosin is a macrolides antibiotic and the active ingredient of

    Tylocip. The soluble salt Tylosin tartrate is approved for poultry as a drinking water

    medication because Tylosin has a wide spectrum of activity against gram positive bacteria

    including Staphylococci and Streptococci, but narrow against gram negative bacteria like

    Campylobacter and Pasteurella multocida and against Mycoplasma gallisepticum, the

    causative agent of Chronic Respiratory Disease in poultry (Annan-Prah et al., 2012).

    However, resistance to Tylosin has been observed (ref). Cross-resistance to other members

    of the macrolides group has been reported especially to erythromycin, which is used

    extensively in human treatments (BAMBio Agri Mix, 2014). Although Tylosin is added to

    feed to promote increased rate of weight gain and improved feed efficiency, it is not

    approved for use as a feed medication for poultry in Canada and European countries (BAM,

    2014; Phillips, 1999). It has been suggested that there are no or minimal benefits using

    antibiotics as growth promoters (Emborg et al., 2001; Engster et al., 2002; World Health

    OrganizationWHO, 20142003). Further, USDA (2009) asserts that the assumed economic

    and production benefits of antibiotics in animal feed can largely be improved by improved

    cleanliness of animal houses and improved testing for diseases. However, World Health

    OrganizationWHO (2000) advises that under no circumstances should antibiotics be used

    as an alternative to high-quality animal hygiene because overuse and abuse of antibiotics

    lead to the emergence of resistant strains in both the birds and man. The use of TNC

    powder presents two problems. The first is that it is a mixture of oxytetracycline,

    Chloramphenicol and Neomycin. The use of Chloramphenicol in veterinary medicine has

    been restricted to non-food animals (Annan-Prah et al., 2012). The United States has

    banned nitrofurans, Chloramphenicol and Ampicilin in animal feed. Germany and the

    Netherlands have forbidden penicillin and tetracycline in feed. Neomycin can worsen

    kidney disease in man (Wongtavatchai et al., 2004). The second issue is that TCN and

    Tylosin have withdrawal periods of 21 days and 10 days respectively, that makes it difficult

    for farmers who use them to wait for withdrawal periods before the sale of eggs or meat.

    Since 49.6% of investigated farms sold their products within the withdrawal periods, they is

    a high possibility for antibiotics residues to be present in these products reason while it is

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    important to monitor the concentration of these residues in other to be sure that they do not

    exceed the MRL.

    In order to assess the occurrence of antibiotics in chicken edible tissues and eggs,

    the HPLC method was used after preliminary qualitative microbiological screening (“data

    not shown”). HPLC was applied to quantitatively determine antibiotics residues in samples

    (Table 4). The antibiotics screened were Chloramphenicol, Tetraxyclin and Vancomycin.

    All the compounds except Vancomycin were detected, and the concentration of these

    antibiotics was higher than the limit set by regulatory authorities Maximum Residual Limit

    (EUEuropean ,Union, 2010). However, no residues of various antibiotics were found in egg

    albumen or yolk. This absence indicate that, the antimicrobial activities of selected eggs

    observed during preliminary qualitative microbiological screening maybe due to the

    presence of other antibiotics different from those use during HPLC. Kan and Petz (2000)

    had noted that drug residues will appear in both egg white and yolk after administration of

    drugs although poultry eggs contain a natural antibiotic substance, lysozyme, against most

    gram positive bacteria (Beuchat and Golden, 1989).

    The levels of Tetraxyclin residues in all the tested samples were greater than the

    recommended MRL as set by the European Union (EU, 2010) regulation commission

    (Table 4). Furthermore, the concentration of Tetraxyclin was significantly high (p

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    The unnecessary use of therapeutic doses of antibiotics or as growth promoters in

    producing animals may be a main cause for the selection of multiple resistant strains of

    bacterial pathogens which can result in serious human and animal infections (World Health

    Organization, 2014Barber et al., 2003). The microbiological analyses of swab samples

    from healthy chicken (Broilers and Layers) allowed in this study for the selection of the

    most common foodborne pathogens responsible of zoonoses diseases. These include among

    other Salmonella sp., Staphylococcus sp., Listeria sp., and Escherichia species (Table 5).

    Proietti et al. (2007) isolated salmonella strains in conventional broiler chickens gastro-

    intestinal tract in central Italy. Neff et al. (2006) during a reference study on the prevalence

    of salmonella in flocks in Switzerland also isolated Salmonella strains. Furthermore,

    salmonella has been known to be the most prevalent pathogen to cause intramammary

    infections in poultry leading to major economic losses (Pengov et al., 2005) and

    Staphylococci may produce a heat stable toxin in contaminated meat, eggs or milk

    (Normanno et al., 2007). AnotherOther serious pathogens such as , Listeria was also

    isolated from samples. Listeria species have been linked with numerous outbreaks

    associated with animal derived products (Lyytikainen et al., 2000). Indeed, Proteus sp. are

    opportunistic diarrhea causes pathogens in poultry. Sambyal and Baxi (1980) had already

    detected occasional presence of bacteria of the genus Proteus in the digestive tract of

    chickens in Punjab in 1980. The other germs identified, namely Clostridium sp., are

    frequent cause of foodborne disease and are also associated with necrotic enteritis in

    chickens (Seyed et al., 2010). In addition, Pseudomonas aeruginosa infections are

    responsible of heavy losses in poultry farms. Furthermore, poor environmental sanitation

    noticed during the farms visits may be the cause of the presence of Shigella sp.,

    Providencia rettgevi and Escherichia species in the analyzed samples. They are generally

    responsible of intestinal infections with more or less diarrhea. Recently, Tatsadjieu et al.

    (2009) isolated Salmonella choleraesuis, Salmonella arizonae, Citrobacter diverticus,

    Aeromonas salmonicida, Bordetella sp., Cedecea lapagei, Vibrio damsel, Proteus mirabilis

    and Pseudomonas cepacia in Broilers and Layers from poultry farms in North Cameroon

    (Ngaoundéré).

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    Studies have shown that E. coli, a normal habitat of human and animal intestines, when

    constantly gets exposed to antibiotics; it develops resistance in order to survive. When these

    resistant isolates are excreted to the environment by faeces, they tend to spread resistance

    genes by vertical gene transfer to pathogens (Sorum and Sunde, 2001; Richard and Yitzhak,

    2014). Thus, this will result in resistance to antimicrobial drugs used in treating infectious

    diseases leading to serious health implications in both humans and animals.

    The above risks are reflected in the results that showed most of all isolated

    microorganisms from samples to be resistant to various classes of antibiotics tested (Table

    6). Interestingly, when comparing the MIC values (in µg/ml) of the pathogenic isolates with

    CLSI’s Minimal Inhibitory Concentration breakpoints for veterinary pathogens, we can

    clearly establish that these microorganisms are resistant. In fact, it is generally noticeable

    that most of the dangerous foodborne pathogens that are Listeria sp., Staphylococcus sp.,

    Salmonella sp., Clostridium sp. and Escherichia species are resistant. 63.64% of all

    pathogens were resistant to Tetracycline, 45.46% to Kanamycin and 63.64% to

    Amoxicillin-clavulanic acid. Moreover, the resistance percentage for Ampicilin was

    54.55%, for Trimethoprim-sulfamethoxazole was 36.36% and 81.82% for Erythromycin.

    Finally, 45.46% of pathogens were resistant to Ceftiofur as well as 36.36%, 45.46%,

    54.56% and 63.64% of them were resistant respectively to Chloramphenicol, Enrofloxacin,

    Gentamycin and Vancomycin. Similar result was reported by Tatsadjieu et al. (2009)

    indicating that the bacteria identified, presented multiresistance to the 11 antibiotics tested.

    Also, our results are in agreement with investigations showing a high prevalence of

    multidrug-resistant bacteria in poultry carcasses (Abdel-Maksoud et al., 2015Ojeniyi, 1989;

    Manie et al., 1998).

    This may indicate that a high percentage of the chicken meat and eggs supply in Western

    Highlands market and in Cameroon in general may contain resistant strains of major

    foodborne pathogens against the mains drugs commonly used in therapeutic treatments;

    thus, incurring a major public health concern. Following the consumption of contaminated

    poultry meat or eggs, resistant bacterial strains may spread to the human population, which

    will lead to the transfer of genes coding for resistance (Bogaard and Stobberingh, 2000;

    Olatoye et al., 2012; Richard and Yitzhak, 2014 ). The dissemination pathways of bacterial

    Formatted: Font: Italic

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    resistance from animals to humans were described earlier by Hummel et al. (1996). Levey

    et al. (1976) also confirmed that in chickens fed Tetracycline, the transfer rate of

    Tetracycline resistance genes between Escherichia coli strains from chicken to chicken and

    from chicken to human was higher.

    In conclusion, antibiotics flood the Cameroonian market as medications and

    growth promoters and their purchase is often without prescription. The general organization

    of poultry production in one of Cameroon’s important agro-pastoral region (Western

    Highlands) seems to rely on heavy doses of antibiotics to cover up hygiene deficiencies in

    their farm operations. Dosage and administration of antibiotics were often subjective and

    withdrawal periods were not observed in many cases. The direct consequence was firstly

    the quantification by HPLC of elevated amount of antibiotics residues in edible tissues

    greater than the recommended MRL and secondly by the identification of various resistance

    pathogens to the mains classes of antibiotics used. However, in order to reduce emergency

    of these resistant’s pathogenic bacteria and subsequent contamination of poultry meat and

    egg, it is critical that risk reduction strategies are used throughout the food chain. Also, it is

    suggested that the relevant government agencies like the Veterinary Services, Food and

    Drugs Board, Ministry of Livestock, Fisheries and Animal Industries, Ministry of Public

    Health, Cameroon Poultry Farmers Association such as IPAVIC (“Interprofession Avicole

    du Cameroun”) and consumers associations make advocacy for enacting and enforcing

    regulations on food hygiene and use of antibiotics.

    RECOMMENDATIONS

    - Cameroon’s veterinary sStakeholders must come together to enact guidelines

    regulatinggood farming practices the presence of antibiotic residues in food and enforce

    them to promote hygiene compliance in poultry farms.

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    - Furthermore, farmers should consult veterinarians and veterinary pharmacists or

    trained auxiliaries for a better advice on the type and quantity of antibiotics to be use as

    well as the respect of withdrawal period.

    - Consumer associations should be more aware of the public health concern related to

    the presence of antibiotics residues in animal derived food and the generation of

    multiresistants pathogenic bacteria.

    - Finally, the use of alternatives to antibiotics such as Probiotics, Prebiotics and

    Synbiotics as well as plant-derived antimicrobial substances and Charcoals may represent a

    promising option in the near future.

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    Tollefson, L. & Miller, M.A. (2000) Antibiotic use in food animals: controlling the human

    health impact. Journal of AOAC International, 83: 245-256.

    Turkson, P.K. (2008) Use of drugs and antibiotics in Ghana. Ghana Journal of Agric. Science,

    41: 23-33.

    USDA. (2009) The transformation of U.S. livestock agricultural scale, efficiency and risks.

    United States Department of Agriculture, 35.

    WHO. (2003) Impacts of antimicrobial growth promoter termination in Denmark. The WHO

    international review panel’s evaluation of the termination of the use of Antibiotic growth

    promoters in Denmark.

    WHO. Antimicrobial resistance: global report on surveillance. Geneva: WHO Press; 2014.

    WHO.2013. Antimicrobial resistance, Fact sheet N°194

    WHO. (2000) Overcoming Antibiotic resistance. WHO, 2000.

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    26

    Wongtavatchai, J., McLean, J.G., Ramos, F. & Arnold, D. (2004) CHLORAMPHENICOL.

    WHO Food Additives Series, 53.

    Woodward, K.N. (1993) Antibiotics and drugs uses in food production. Encyclopedia of Food

    Science, Food Technology and Nutrition, 249.

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    Figure: Georeference of investigated poultry farms in the Western Highlands of Cameroon. The georeference of each poultry farms was collected by the use of a Global Positioning System (GPS) receiver (GPSmap

    76CSx, Garmin). Each point spot (•) represents a poultry farm. Each square spot (■) represents a town. The

    following symbols (————) and (•••••••••) indicate primary and secondary route respectively. 98x92mm (96 x 96 DPI)

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    Table 1: Percentage of poultry farmers whom have received an appropriate training, are

    regularly medically examined and their education levelEducational status of staff of farms*

    Factors Frequency (n=131)

    Education level

    Illiterate 0 (0)

    Basic Education 20 (15)

    Secondary/Vocational 90 (68)

    Tertiary 20 (15)

    No answer 1(1)

    Training on poultry farming

    Trained 70 (53)

    Untrained 61(47)

    Medical examination

    Medically examined 15 (11)

    Medically unexamined 116 (89)

    *Percentages are in parenthesis

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    Table 2: Knowledge of farmers on withdrawal period and it application as well as the rationale

    of usage and the factors they based on to select antibiotics Antibiotic usage and handling*

    Factors Frequency (n=131)

    Rationale for usage

    In disease outbreak 40 (31)

    Prophylactic use 05 (4)

    Prophylactic and curative 86 (66)

    Reasons for choice

    Cost 117 (89)

    Availability 96 (73)

    Potency 26 (20)

    Veterinary prescription 24 (20)

    Farmer prescription 98 (80)

    Cost 117 (89)

    Knowledge and respect of withdrawal period

    Aware of withdrawal period 61 (46.6)

    Respect of withdrawal 55 (42.0)

    Sales of products within antibiotic withdrawal

    period

    65 (49.6)

    No sales of produce within antibiotic

    withdrawal period for eating

    55 (42.0)

    Aware of withdrawal period 61 (46.6)

    Respect of withdrawal 55 (42.0)

    *Percentages are in parenthesis

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    nlyTable 3: Percentage of antimicrobials used in investigated farms in the Western Highlands of

    Cameroon. The informations were collected by the use of a well structure questionnaire written

    in English and French Antimicrobials used in investigated farms

    Antimicrobials used Active ingredients Withdrawal period Total Percentage

    (N= 131)

    Hipralona Nor-S

    Norfloxacin 200mg

    NI*

    49

    37.4%

    Enrofloxacin &

    Bromhexin HCl solution

    Enrofloxacin 200mg

    NI

    35

    26.7%

    Amprolium

    NI

    NI

    3

    2.29%

    Norfloxan 20%

    Norfloxacin 200mg

    4 days

    40

    30.53%

    Anticoc super

    Sodium sulfadimerazin 860g

    and diaveridin 105g

    NI

    18

    13.74%

    Enroveto – 20

    Enrofloxacin 200mg

    7days for meat and do not

    use in layers

    38

    29.00%

    Oxyveto -50S

    Oxytetraxyclin 500mg

    7 days

    121

    93%

    Vetacox S

    Sodium Sulfadimidin 80g & diaveridin 8g

    14 days

    84

    64%

    TCN powder

    Oxytetraxyclin HCL 50mg

    Chloramphenicol 50mg

    Neomycin sulphate 25mg

    21 days

    88

    67.18%

    T.T.S

    Trimethoprim 4g

    sodium sulfadiazine 18.88g

    12days

    20

    15.3%

    BioPHA-FF

    Flumequin 40g and Furaltadon 45g

    NI

    64

    49%

    Doxylin 200 wsp

    Doxyciclin 200mg

    7days

    65

    49.62%

    Vet – colis 200 wsp

    Colistin Sulphate 200mg

    7days

    53

    40.5%

    Formatted: No underline

    Formatted: Font: Not Bold

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    Oxytetraxyclin 50%

    Oxytetraxyclin 500mg

    7days

    100

    76.34%

    Tylocip 20%

    Tylosin 200mg

    NI

    115

    87.8%

    Ganadexil Enrofloxacina

    Enrofloxacin 100mg

    4 days for broiler and do not

    use in layers

    35

    26.7%

    Anticox

    Sodium Sulfadimidin 80g +& diaveridin 8g +

    vitamin K

    12 days for both broilers

    and layers

    79

    60.3%

    Diclacox

    Diclazuril 1000mg

    5 days

    33

    25%

    Trisulmycin

    NI NI

    46

    35%

    Colidox Forte

    Colistin 5000I and Doxycyclin 200mg

    7 days for both broilers

    and layers

    76

    58%

    Tetracolivit

    Oxytetracyclin 100mg + Colistin 7000I

    + vitamins

    7 days for broilers and nil for

    layers

    69

    52.7%

    Oxyvancovit Oxytetracyclin 150mg + Vancomycin 125mg

    + vitamins

    NI 100 76.34%

    LEVA-200wsp Levamisole 200mg 2 days for both broilers

    and layers

    70

    3.44%

    Amprolium 300ws Amprolium 200mg 3 days for both broilers

    and layers

    94 72%

    Oxydavit NI NI 18 13.74%

    Levalap

    Levamisole 200mg

    2 days for both broilers

    and layers

    60

    45.8%

    *NI=No Indication about the withdrawal period or about the active compounds

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    nlyTable 4: Concentration of Chloramphenicol, Tetracyclin and Vancomycin in edible tissues as

    quantified by HPLC with comparison to MRL (Maximum Residue Limits) defined by the

    European Union (EU) regulation commission No 37/2010 Concentration of antibiotics residues

    in various tissues

    Antibiotic Sample Residues level

    (µg/g)

    MRLs*

    (µg/g)

    Judgment

    Chloramphenicol

    muscle 1.4366 ± 0.3216a

    Prohibited substance

    (MRL cannot be established)

    Rejected

    gizzards Not detectable b

    heart Not detectable 0.000

    ± 0.000 b

    kidney Not detectable 0.000

    ± 0.000 b

    liver Not detectable 0.000

    ± 0.000 b

    Egg white Not detectable 0.000

    ± 0.000 b

    Egg yolk Not detectable 0.000

    ± 0.000 b

    Tetracyclin

    muscle 62.4380 ± 15.3261b 0.1 Rejected

    gizzards 21.3290 ± 4.3278c ND** Rejected

    heart 1615.950 ± 9.7629c ND Rejected

    kidney 8.9780 ± 4.9878d 0.6 Rejected

    liver 150.030 ± 30.8780a 0.3 Rejected

    Egg white Not detectable0.000

    ± 0.000e

    0.2 Pass

    Egg yolk Not detectable0.000

    ± 0.000e

    0.2 Pass

    Vancomycin

    muscle Not detectable 0.000

    ± 0.000 a

    Prohibited substance

    (MRL cannot be established)

    Rejected gizzards Not detectable 0.000

    ± 0.000 a

    heart Not detectable 0.000

    ± 0.000 a

    kidney Not detectable 0.000

    Formatted: Font: Not Bold

    Formatted: Font: Not Bold

    Formatted: Font: Not Bold

    Formatted: Font: Not Bold, Not Italic

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    nly± 0.000 a

    liver Not detectable 0.000

    ± 0.000 a

    Egg white Not detectable 0.000

    ± 0.000 a

    Egg yolk Not detectable 0.000

    ± 0.000 a

    *MRLs: Maximum Residue Limits, according to European Union (EU) regulation commission No 37/2010 [45]

    **ND: Not defined; Number having the same letter are not significantly different (p>0.05).

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    Table 5: Percentage of pathogenic strains isolated from chicken faeces using selective and semi-

    selective growth media and identified by the use of API 20E, API Staph and API 20NE

    systemsPathogenic strains isolated and identified

    Name of strains Percentage (%) of isolates (N= 28)

    Clostridium sp. 7.14

    Escherichia vulneris 10.71

    Proteus vulgaris 7.14

    Proteus mirabilis 10.74

    Providencia rettgevi 10.71

    Pseudomonas aeruginosa 3.57

    Staphylococcus sciuri 7.14

    Staphylococcus epidermidis 7.14

    Salmonella sp. 17.86

    Listeria sp. 10.71

    Shigella sp. 7.14

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    nlyTable 6: Percentage of antibiotic susceptibility of pathogenic strains isolated from chicken faeces as

    interpreted according to the FEEDAP (Panel on Additives and Products or substances used in Animal

    Feed) document of the EFSA (European Food Safety Authority) and the standards set by the CLSI

    (Clinical Laboratory Standards Institute), formerly National Committee for Clinical Laboratory Standards

    Resistance percentage of pathogenic bacteria isolated from poultry

    Resistant percentage of isolated pathogenic strains

    Antibiotics tested

    pathogenic strains GEN KAN AMC AMP ENR ERY XNL CHL SXT TET VAN

    Clostridium sp. 0 100 100 ND* 100 0 100 0 0 100 0

    Escherichia vulneris 100 0 0 100 100 100 0 0 0 0 0

    Proteus vulgaris 0 0 100 100 0 0 0 0 100 100 100

    Proteus mirabilis 0 0 0 0 0 100 0 0 100 0 100

    Providencia rettgevi 100 0 0 0 0 100 100 100 0 100 100

    Pseudomonas

    aeruginosa

    0 100 100 100 0 100 0 0 100 100 0

    Staphylococcus sciuri 100 100 100 100 100 100 0 100 0 0 100

    Staphylococcus

    epidermidis

    100 100 100 100 100 100 0 0 0 0 100

    Salmonella sp. 100 100 100 100 100 100 100 100 100 100 100

    Listeria sp. 100 0 0 0 0 100 100 0 0 100 0

    Shigella sp. 0 0 100 0 0 100 100 100 0 100 100

    Percentage of resistant

    isolates/antibiotics

    54.56% 45.46% 63.64% 54.55% 45.46% 81.82% 45.46% 36.36% 36.36% 63.64% 63.64%

    *ND: Not Defined; GEN= Gentamycin; KAN= Kanamycin; AMC=Amoxicillin-clavulanic acid; AMP= Ampicilin;

    ENR=Enrofloxacin; ERY=Erythromycin; XNL= Ceftiofur; CHL=Chloramphenicol; SXT=Trimethoprim-

    sulfamethoxazole; TET= Tetracycline; VAN= Vancomycin

    Formatted: Font: 11 pt, Not Bold

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    -Dear brother / sister:

    -This questionnaire was developed in order to collect data on the use of antibiotics in poultry farms.

    - On the last page, you can add information and comments that you consider useful in the practice of antibiotic

    therapy in this type of farming.

    - With your valuable cooperation. Please accept dear brother, / sister, best regards.

    ------------------------------------------------------------------------------------------------------------------------------------------

    1. What is the importance of poultry activity in your life (check one)?

    - Main activity [ ] - Secondary activity [ ]

    2. What kind of speculation you generally follow?

    - Broiler [.....] - Local chicks [.....] - Laying Hen [.....] - started [.....] - Broiler- Laying Hen [.....]

    3. What is the herd size of animals in the current production?

    ............................................................................................................................................................................................

    4. What are the main pathologies encountered?

    Major Diseases

    Speculation Digestive Breathing Nervous Locomotor App. Nutritional

    Broiler -

    Laying Hen

    Local chicks

    5. Which antibiotic molecules do you use?

    Furaltadon [.......] Flumequin [.......] Amoxicillin [.......] Céfixime [.......] Oxytetracyclin [.......] Streptomycin [.......]

    Colistin [.......] Nitrofurantoïn [.......] Neomycin [.......] Norfloxacin [.......] Vetpro-E [.......] Vetacox [.......] Aliseryl

    [.......] Fumesol [.......] Erythromycin [.......] Penicillin [.......] Ampicilin [.......] Tetracyclin [.......] T.T.S [.......]

    Chloramphenicol [.......] Doxycyclin [.......] Ciprofloxacin [.......] Bactrim (Cotrimodazole) [.......] Sulphamides [.......]

    Trimethoprim [.......] Flagyl (Metronidazole) [.......] Vermox (Mebendazole) [.......] Sulfadiazin [.......] Tylosin [.......]

    Other ............/ ............/ ............/ ............/ ............/ ............/ ............/ ............./ ............/ ............/ ............/ ............./

    UNIVERSITE DE DSCHANG

    UNIVERSITY OF DSCHANG

    ***********

    FACULTE DES SCIENCES

    FACULTY OF SCIENCE

    ***********

    DEPARTEMENT DE BIOCHIMIE

    DEPARTMENT OF BIOCHEMISTRY

    *********

    BP: 67 Dschang Cameroun

    Tel: (237) 33 45 17 35

    REPUBLIQUE DU CAMEROUN

    Paix-Travail-Patrie

    REPUBLIC OF CAMEROON

    Peace-Work-Fatherland

    Date:...........................................................

    GPS:...........................................................

    *REGION............................................. *DEPARTMENT..............................

    IDENTIFICATION *DISTRICT........................................... *QUARTER......................................

    *NAME OF THE FARM...................... *TYPE OF OPERATION Poultry □

    * EDUCATION.................................... Mixed Farming □

    ACADEMIC INQUIRY FOR A DOCTORAL THESIS/PhD

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    6. For what purpose do you use antibiotics?

    - Curative (in disease outbreak) [ ] - Prophylactic [ ] - Prophylactic and Curative [ ]

    7. How do you choose antibiotics to be given to animals?

    Personal selection [ ] - Cost [ ] – Availability [ ] – Efficacy (Potency) [ ] - Veterinary prescription [ ] - Drug dealer

    prescription [ ] - Other ............/ ............/

    8. Where do you purchase the antibiotics?

    -Veterinary Pharmacy [ ] - Farm Pharmacy [ ] - Local market [ ] - Other ............/ ............/

    9. Who generally administer the antibiotic?

    - Yourself [ ] - The Veterinary doctor [ ] - Other ............/ ............/

    10. How do you administer the antibiotic?

    - Water [ ] - Food [ ] - Gavage [ ] - Other ............/ ............/

    11. When do you stop the antibiotic treatment?

    - Disappearance of symptoms (even before the end of the specified time) [ ]

    - End of the recommended amount of the drug [ ]

    12. Practically, how do you establish the dosage?

    - Count the animals [ ] - Estimation [ ] - Weighing (with scale) [ ] - Following Sheet [ ] - Estimation [ ] -Vet instructions [ ]

    13. What is the frequency of administration of antibiotics by production cycle?

    - 1 time [ ] -2 times [ ] -3 times [ ] - continuously [ ] - Depending on outbreak of diseases [ ] - Other ........../

    14. What quantity of antibiotics do you use per production cycle of 100 chickens?

    - 50g [ ] - 100g [ ] - 150g [ ] - 200g [ ] - 250g [ ] - 300g [ ] - 350g [ ] - 400g [ ] - 450g [ ] - 500g [ ] - Other........../

    15. Do you know the concept of « withdrawal period»?

    - Yes [ ] - No [ ]

    16. If yes, do you observe these deadlines?

    - Yes [ ] - No [ ]

    17. What is the duration of the « withdrawal period» you observe?

    - 0 day [ ] - 2 days [ ] - 4 days [ ] - 6 days [ ] - 7 days [ ] - 8 days [ ] - 10 days [ ] - 12 days [ ] - 14 days [ ]

    - 15 days [ ] - 16 days [ ] - 17 days [ ] - 18 days [ ] - 19 days [ ] - 20 days [ ] - Other ........../ ........../ ........../ ........../

    18. Do you sale the animals during this withdrawal period?

    - Yes [ ] - No [ ]

    19. Have you received training on poultry farming?

    - Yes [ ] - No [ ]

    20. Are you often medically examined?

    - Yes [ ] - No [ ]

    Thanks for your collaboration and time spent completing this questionnaire

    INFORMATION AND/OR NOTES

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